Department of Empowerment of Persons with Disabilities,

Ministry of Social Justice and Empowerment, Government of India

Disability Certificate
Issuing Medical Authority, Hapur, Uttar Pradesh

Certificate No.: UP7510619920004003 Date: 09/03/2006

This is to certify that I/We have carefully examined Shri Yogendra Kumar Son of Shri Rajveer Singh Date of Birth
26/01/1992 Age 26 Year(s) Male, Registration No. 0975/00000/1806/0116462 resident of House No. Vill
Lukhrara, Post Sheikhpur, Distt Hapur - 245201 Sub District Hapur District Hapur State / UTs Uttar Pradesh
Whose photograph is affixed above, and I/We satisfied that:

(A) He is a case of Locomotor Disability

(B) The diagnosis in his case is PPRP RIGHT LOWER LIMB

(C) He has 45%(in figure) Forty Five percent(in words) Permanent in relation to his (part of body) as per guidelines
(to be specified).

The applicant have been submitted the following document(s) as proof of residence
Nature of Document(s): Aadhaar card

Signature / Thumb impression of the Person With Disability

Signatory of notified Medical Authority Member

Issuing Medical Authority, Hapur, Uttar Pradesh

This Card/Certificate is meant to certify the disability of the person and is not an instrument for ID/Address Proof for any
purpose.